The Biomechanical Analysis of Magnitude and Direction of Force by Different Techniques of Thoracic Spinal Manipulation

Joo, Sunghee; Kim, Junghyun; Lee, Yong-Woo; Song, Changho

doi:10.1155/2020/8928071

Cited by 5 publications

(6 citation statements)

References 27 publications

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“…In the current study, the vertical (F z ) preload and total peak forces (234.9 N (±36.5) and 462.1 N (±52.3), respectively) as well as the resultant preload and peak forces (260 N (±41.7) and 470.1 N (±46.4), respectively) measured at the clinicianparticipant interface were comparable to the ones previously reported in the literature. On the participant-table interface, previous studies using similar measurement instrument (i.e., force plate) reported preload forces between 157.7 N to 299.6 N and total peak forces of between 432.3 N and 625.4 N in adults younger than 30 years old (Cambridge Joo et al, 2020). Although trending towards the lower force range, comparable SMT preload and total peak forces were observed at the participant-table interface in this study.…”

Section: Discussionsupporting

confidence: 77%

“…Fig. 2 presents preload and total peak force magnitudes of spinal mobilization and spinal manipulative therapy measured in the current study and reported in previous studies with younger adults (Cambridge et al, 2012;Forand et al, 2004;Herzog et al, 2001;Joo et al, 2020;Kirstukas and Backman, 1999;Snodgrass et al, 2006;Van Zoest and Gosselin, 2003) at the clinician-participant and participant-table interfaces for qualitative comparison.…”

Section: Qualitative Comparison With Previous Studiesmentioning

confidence: 99%

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Characterization of thoracic spinal manipulation and mobilization forces in older adults

Funabashi

Son

Pecora

et al. 2021

Clinical Biomechanics

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Background: Spinal mobilization and spinal manipulation are common interventions used by manual therapists to treat musculoskeletal conditions in older adults. Their force-time characteristics applied to older adults' thoracic spine are important considerations for effectiveness and safety but remain unknown. This study aimed to describe the force-time characteristics of posterior-to-anterior spinal mobilization and manipulation delivered to older adults' thoracic spine. Methods: Twenty-one older adults (≥65 years) with no thoracic pain received posterior-to-anterior thoracic spinal mobilization and/or manipulation with the force characteristics a chiropractor deemed appropriate. Sixdegree-of-freedom load cells and an instrumented treatment table recorded the force characteristics of both interventions at the clinician-participant and participant-table interfaces, respectively. Preload force, total peak force, time to peak and loading rate were analyzed descriptively. Findings: Based on data from 18 adults (56% female; average: 70 years old), mean resultant spinal mobilization forces at the clinician-participant interface were: 220 ± 51 N during preload, 323 ± 67 N total peak force, and 312 ± 38 ms time to peak. At the participant-table interface, mobilization forces were 201 ± 50 N during preload, 296 ± 63 N total peak force, and 308 ± 44 ms time to peak. Mean resultant spinal manipulation forces at the clinician-participant interface were: 260 ± 41 N during preload, 470 ± 46 N total peak force, and 165 ± 28 ms time to peak. At the participant table interface, spinal manipulation forces were 236 ± 47 N during preload, 463 ± 57 N total peak force, and 169 ± 28 ms time to peak. Interpretation: Results suggest older adults experience unique, but comparable force-time characteristics during spinal mobilization and manipulation delivered to their thoracic spine compared to the ones delivered to younger adults described in the literature.

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Section: Discussionsupporting

confidence: 77%

Section: Qualitative Comparison With Previous Studiesmentioning

confidence: 99%

Characterization of thoracic spinal manipulation and mobilization forces in older adults

Funabashi

Son

Pecora

et al. 2021

Clinical Biomechanics

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show abstract

“…The initial peak force was set at 200 N, and increased in 100 N increment to reach a maximum peak force of 600 N. Each peak force was delivered using an increasing rate of force application ranging from 500 N/s to 2500 N/s, in 500 N/s increments. The force–time characteristics used in this study were based on the ones reported in the literature [ 17 – 19 ]. The lowest peak force was first delivered with the five different rates of force application, then the second-lowest peak force was delivered, and so on until the highest peak force was delivered with the highest rate of force application.…”

Section: Methodsmentioning

confidence: 99%

Investigation of the factors influencing spinal manipulative therapy force transmission through the thorax: a cadaveric study

Mikhail,

Funabashi,

Sobczak

et al. 2023

Chiropr Man Therap

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Background Spinal manipulative therapy (SMT) clinical effects are believed to be linked to its force–time profile characteristics. Previous studies have revealed that the force measured at the patient-table interface is most commonly greater than the one applied at the clinician-patient interface. The factors explaining this force amplification remains unclear. Objective To determine the difference between the force applied to a cadaveric specimen’s thoracic spine and the resulting force measured by a force-sensing table, as well as to evaluate the relationship between this difference and both the SMT force–time characteristics and the specimens’ characteristics. Methods Twenty-five SMTs with different force–time profiles were delivered by an apparatus at the T7 vertebra of nine human cadaveric specimens lying prone on a treatment table equipped with a force plate. The difference between the force applied by the apparatus and the resulting force measured by the force plate was calculated in absolute force (Fdiff) and as the percentage of the applied force (Fdiff%). Kinematics markers were inserted into T6 to T8 spinous and transverse processes to evaluate vertebral displacements during the SMT thrusts. Mixed-effects linear models were run to evaluate the variance in Fdiff and Fdiff% explained by SMT characteristics (peak force, thrust duration and force application rate), T6 to T8 relative and total displacements, and specimens’ characteristics (BMI, height, weight, kyphosis angle, thoracic thickness). Results Sixty percent of the trials showed lower force measured at the force plate than the one applied at T7. Fdiff¸ was significantly predicted (R2marginal = 0.54) by peak force, thrust duration, thoracic thickness and T6–T7 relative displacement in the z-axis (postero-anterior). Fdiff% was significantly predicted (R2marginal = 0.56) by force application rate, thoracic thickness and total T6 displacements. For both dependant variables, thoracic thickness showed the highest R2marginal out of all predictors. Conclusion Difference in force between the clinician-patient and the patient-table interfaces is influenced by SMT force–time characteristics and by thoracic thickness. How these differences in force are associated with vertebral displacements remains unclear. Although further studies are needed, clinicians should consider thorax thickness as a possible modulator of forces being transmitted through it during prone SMT procedures.

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“…The initial peak force was set at 200 N and increased with an increment of 100 N for a maximum peak force of 600 N. Each peak force was delivered using an increasing rate of force application ranging from 500 N/s to 2500 N/s with increment of 500 N/s. The force-time characteristics used in this study were based on pro les reported in the literature [14,15]. The lowest peak force was rst delivered with the ve different rates of force application, then the second lowest peak force was delivered, and so on until the higher peak force was delivered with the highest rate of force application.…”

Section: Smt Applicationmentioning

confidence: 99%

Investigation of the factors influencing spinal manipulative therapy force transmission through the thorax: a cadaveric study

Mikhail¹,

Funabashi²,

Sobczak³

et al. 2023

Preprint

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Background Spinal manipulative therapy (SMT) clinical effects are believed to be linked with its force-time profile characteristics. Previous studies have revealed that the force measured at the patient-table interface is most commonly higher than the force applied at the clinician-table interface. The factors explaining this force amplification remains unclear. Objective To determine the difference between the force applied on cadaveric specimen’s thoracic spine and the resulting force measured by a force-sensing table as well as to evaluate the relationship between this difference of force and both the SMT force-time characteristics and the specimen characteristics. Methods Twenty-five SMTs with different force-time profiles were delivered by an apparatus at the T7 vertebra of 9 human cadaveric specimens lying prone on a treatment table instrumented with a force plate. The difference between the force applied by the apparatus and the resulting force measured by the force plate was calculated (Fdiff). Difference in force was also expressed as the percentage of the applied force (Fdiff%). Kinematics markers were inserted into T6 to T8 spinous and transverse processes to evaluate vertebral displacements during SMT thrusts. Mixed-effects linear models were conducted to evaluate the variance in Fdiff and Fdiff% explained by SMT characteristics (peak force, thrust duration and rate of force), T6 to T8 relative and total displacements, and specimens’ characteristics (BMI, height, weight, kyphosis angle, thoracic thickness). Results Sixty percent of the trials showed lower force measured at the force plate than the one applied at T7. Fdiff¸ was significantly predicted (R2marginal = 0.54) by peak force, thrust duration, thoracic thickness and T6-T7 relative displacement in the z-axis. Fdiff% was significantly predicted (R2marginal = 0.56) by rate of force application, thoracic thickness and T6 total displacements. For both dependant variables, thoracic thickness showed the highest R2marginal out of all predictors. Conclusion Difference in force between the clinician-patient and the patient-table interfaces is influenced by SMT force-time characteristics and by the thoracic thickness. How these differences in force are associated with vertebral displacements remains unclear. Future investigations should measure SMT force-time profiles at both interfaces and normalization with thoracic thickness should be considered when measuring force at the patient-table interface.

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The Biomechanical Analysis of Magnitude and Direction of Force by Different Techniques of Thoracic Spinal Manipulation

Cited by 5 publications

References 27 publications

Characterization of thoracic spinal manipulation and mobilization forces in older adults

Characterization of thoracic spinal manipulation and mobilization forces in older adults

Investigation of the factors influencing spinal manipulative therapy force transmission through the thorax: a cadaveric study

Investigation of the factors influencing spinal manipulative therapy force transmission through the thorax: a cadaveric study

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